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1. What are the criteria for differential diagnosis between aplastic anemia and acute leukemia:
A. [ ] Anemic syndrome
B. [X] Proliferative syndome
C. [ ] Hemorrhagic syndrome
D. [ ] Pancytopenia in the peripheral blood count
E. [X] Blast cells over 20% in the bone marrow aspirate
2. What morphological features are observed in iron-deficiency anemia:
A. [X] Hypochromia of erythrocytes
B. [ ] Hypersegmentation of neutrophil nuclei
C. [X] Microcytosis of erythrocytes
D. [ ] Targeted erythrocytes
E. [ ] Microspherocytes
3. The following statements are suitable for diagnosis of iron-deficiency anemia, with an exception of:
A. [ ] Angular stomatitis
B. [ ] “Pica chlorotica”
C. [X] Paresthesia in fingers of hands and feet
D. [X] Wax-like nuance of the skin
E. [ ] Hypochromia of erythrocytes
4. Iron-deficiency anemia should be differentiated commonly from:
A. [ ] Vitamin B12- deficiency anemia
B. [ ] Folic acid-deficiency anemia
C. [ ] Aplastic anemia
D. [X] Marchiafava-Micheli disease
E. [X] Thalassemia
5. Aplastic anemia is manifested by:
A. [X] Anemic syndrome
B. [ ] “Pica chlorotica”
C. [ ] Proliferative syndome
D. [ ] Sideropenic syndrome
E. [X] Hemorrhagic syndrome
6. Iron-deficiency anemia is manifested by:
A. [X] Perversion of tastes
B. [ ] Hemorrhagic syndrome
C. [ ] Neurologic syndrome
D. [X] Sideropenic syndrome
E. [ ] Paresthesia in fingers
7. Sideropenic syndrome is characterized by the following clinical manifestations:
A. [X] Hair and nails fragility
B. [ ] Skin jaundice
C. [X] “Pica chlorotica”
D. [ ] Splenomegaly
E. [ ] Lymph nodes enlargement
8. The following drugs are used for treatment of iron-deficiency anemia:
A. [ ] Vitamin B12
B. [ ] Folic acid
C. [ ] Polyvitamins
D. [X] Hemofer
E. [X] Sorbifer-Durules
9. Vitamin B12- deficiency anemia may be caused by:
A. [ ] Hiatal hernia
B. [X] Diffuse atrophy of the gastric mucosa
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34. What of the following blood count parameters are compatible with diagnosis of aplastic anemia:
A. [ ] Thrombocytosis
B. [ ] Reticulocytosis
C. [X] Leukopenia
D. [X] Thrombocytopenia
E. [ ] Leukocytosis over 15.0 x 109/l
35. Clinical picture of aplastic anemia comprises the following syndromes:
A. [ ] Neurologic
B. [ ] Sideropenic
C. [X] Hemorrhagic
D. [X] Infections occurs frequently
E. [ ] Proliferative
36. The following statements are compatible with diagnosis of hereditary microspherocytosis:
A. [X] The disease may evolve with aplastic crisis
B. [ ] The hemolysis takes place mainly in the bone marrow and to a limited extent in the spleen
C. [ ] The correction of anemia needs high doses of iron preparations
D. [X] Red cell membrane proteins are genetically altered
E. [ ] Splenectomy is absolutely contraindicated
37. Intravascular hemolysis is characterized by:
A. [X] Release of hemoglobin into plasma
B. [ ] Increased values of hemopoietin
C. [ ] Dominant spleen involvement in erythrocyte distruction
D. [X] Hemoglobinuria and hemosiderinuria
E. [ ] Clinical evolution of chronic hemolysis
38. The diagnosis of thalassemia is proved by the following criteria:
A. [ ] Decreased plasma iron concentration
B. [ ] Positive Ham test
C. [X] Increased values of hemoglobin F during electrophoresis of hemoglobin
D. [X] Marked splenomegaly
E. [ ] Decreased osmotic resistance
39. The following hemostasis alterations are present in thrombocytopenic purpura:
A. [X] Prolonged bleeding time
B. [ ] Absence or decrease of concentration of factor VIII
C. [X] Decrease of platelets count
D. [ ] Decreased prothrombin index
E. [ ] Presence of fibrin monomers
40. A fertile woman with thrombocytopenic purpura may have the following changes of the peripheral
blood count:
A. [ ] Leukopenia
B. [X] Posthemorrhagic anemia
C. [ ] Lymphocytosis
D. [ ] Presence of blast cells
E. [X] Decreased platelets count
41. The following statements are suitable for diagnosis of thrombocytopenic purpura:
A. [ ] Clot retraction is normal
B. [X] Prolonged bleeding time
C. [ ] Hereditary coagulation disorder
D. [X] Decreased platelets count
E. [ ] Prolonged coagulation time by Lee-White
42. The prolonged bleeding time is registered in:
A. [X] Thrombocytopenic purpura
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B. [ ] Hemophilia
C. [ ] Rendu-Osler disease
D. [ ] Hemorrhagic capillary toxicosis
E. [X] Von Willebrand disease
43. The prolonged coagulation time is registered in:
A. [ ] Thrombocytopenic purpura
B. [X] Hemophilia
C. [ ] Rendu-Osler disease
D. [X] Von Willebrand disease
E. [ ] Hemorrhagic capillary toxicosis
44. The following laboratory data prove the diagnosis of hemophilia:
A. [ ] Prolonged bleeding time
B. [ ] Decreased platelets count
C. [X] Prolonged coagulation time by Lee-White
D. [ ] Decrease of prothrombin index
E. [X] Increase of partial activated thromboplastine time
45. Hemophilia is characterized by:
A. [X] Hemarthroses and hematomas
B. [ ] Decrease of platelets count
C. [X] Increase of partial activated thromboplastine time
D. [ ] Prolonged bleeding time
E. [ ] Hemorrhagic syndrome in the form of petechias and ecchymoses
46. The diagnosis of Hodgkin lymphoma with the involvement of mediastinal lymph nodes should be proved by:
A. [ ] X-ray examination
B. [X] Mediastinoscopy with biopsy
C. [ ] Ultrasound scanning
D. [X] Exploratory Thoracotomy with biopsy
E. [ ] Computerized tomography scanning
47. The following statements are characteristic for Hodgkin lymphoma:
A. [ ] Central nervous system involvement is the most frequent extranodal localization
B. [ ] Histological type has no prognostic value
C. [X] Histological type has a prognostic value
D. [ ] The increase of alcaline phosphatase indicates the involvement of mediastinal lymph nodes
E. [X] Immune deficiency
48. The following statements may be related to the treatment of Hodgkin lymphoma:
A. [ ] Single-agent chemotherapy constitutes the first-line treatment option in patients with localized stages
B. [X] The treatment modality is ellaborated according to the stage and histological type of the tumor
C. [ ] Radiotherapy is applied only in generalized stages
D. [ ] Patients with stage I of the tumor don’t need specific treatment
E. [X] In patients with stage IV Hodgkin lymphoma, the main treatment option is combined chemotherapy
49. The are following high grade histological types of non-Hodgkin lymphoma:
A. [X] Lymphoblastic
B. [ ] Prolymphocytic
C. [ ] Lymphocytic
D. [X] Immunoblastic
E. [ ] Lymphoplasmacytic
50. The unfavorable evolution of non-Hodgkin lymphoma is asserted by:
A. [ ] Prolymphocytic type
B. [X] Leukemic conversion with blast cells
C. [X] Generalized stages
D. [ ] Localized stages
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59. What of the following statements are compatible with diagnosis of chronic lymphocytic leukemia:
A. [X] Infectious complications occurs frequently
B. [ ] The first-line treatment comprises Melphalan
C. [X] Leukocytosis is caused by the absolute lymphocytosis
D. [ ] Polyclonal character of lymphoid infiltration
E. [ ] The cause of anemia is always autoimmune hemolysis
60. Chronic lymphocytic leukemia is a tumor of hematopoietic system, originating from:
A. [ ] Stem cell
B. [X] Lymphoid B-cell precursor
C. [X] Lymphoid T-cell precursor
D. [ ] Myeloid cell precursor
E. [ ] Blast cell
61. The causes of anemia in chronic lymphocytic leukemia are:
A. [ ] Iron deficiency
B. [ ] Vitamin B12 deficiency
C. [X] Autoimmune hemolysis
D. [ ] Bleeding
E. [X] Bone marrow involvement
62. Polycythemia vera may evolve with the following complications:
A. [X] Miocardial infarction
B. [X] Necroses of fingers
C. [ ] Autoimmune hemolysis
D. [ ] Cholelithiasis
E. [ ] Frequent infectious complications
63. What of the following drugs are more efficient in treatment of polycythemia vera:
A. [X] Imifos
B. [X] Hydroxyurea
C. [ ] Cyclophosphamide
D. [ ] Vincristine
E. [ ] Chlorambucil
64. The diagnosis of multiple myeloma may be asserted by the association of the following criteria:
A. [X] Myeloma cells over 15% in the bone marrow aspirate
B. [X] Osteolytic lesions on X-ray examination of the bones
C. [ ] Detection of pathologic paraprotein
D. [ ] Proteinuria
E. [ ] Anemia and accelerated ESR in the peripheral blood count
65. What of the following examinations are mandatory to prove the diagnosis and determine the stage of
multiple myeloma:
A. [X] X-ray examination of the bone skeleton
B. [X] Plasma proteins electrophoresis
C. [ ] Coagulation tests
D. [ ] Determination of bilirubin and aminotransferases concentrations
E. [ ] Neciporenco test of the urine
66. The following statements are suitable for pathogenesis of Rendu-Osler disease:
A. [X] Deficiency or absence of collagen fibers in pericapillary connective tissue
B. [ ] Prolonged prothrombin time
C. [X] Platelets aren’t activated, that leads to the adhesion disorder
D. [ ] Antiplatelets antibodies are formed
E. [ ] Autocoagulation test is altered
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D. [ ] Intravascular
E. [ ] In all above-mentioned sites
84. Morphological examination of erythrocytes in thalassemia reveals:
A. [ ] Microspherocytes
B. [X] Hypochromia
C. [X] Targeted red cells
D. [ ] Elliptocytes
E. [ ] Acantocytes
85. Clinical picture of thalassemia is characterized by:
A. [X] Hemolytic syndrome
B. [ ] Hemorrhagic syndrome
C. [ ] Neurologic syndrome
D. [X] Splenomegaly
E. [ ] Lymph nodes enlargement
86. The patients with thalassemia may have the following complications:
A. [ ] Infectious
B. [X] Secondary hemosiderosis
C. [X] Thromboses
D. [ ] Hemorrhagic syndrome
E. [ ] Autoimmune
87. The following tests are specific for paroxysmal nocturnal hemoglobinuria:
A. [ ] Direct Coombs test
B. [ ] Indirect Coombs test
C. [X] Ham test
D. [X] Test with sucrose
E. [ ] Sickling test
88. Heteroimmune hemolytic anemias develop as a result of:
A. [ ] Action of antierythrocyte antibodies
B. [ ] Mechanical distruction of red cells
C. [ ] Structural alterations of red cell membrane
D. [X] Production of antibodies against erythrocytes, in which some drugs are bound to membrane
E. [X] Production of antibodies against erythrocytes, in which some viruses are bound to membrane
89. The following criteria plead for autoimmune hemolytic anemia with antibodies against nucleated
red cells of the bone marrow:
A. [ ] Erythroid hyperplasia of the bone marrow
B. [ ] Reticulocytosis
C. [X] Absence of reticulocytosis
D. [X] Total or subtotal absence of erythrocaryocytes in the bone marrow
E. [ ] Bilirubinemia
90. The following drugs are used for treatment of acute lymphoblastic leukemia:
A. [ ] Melphalan
B. [ ] Busulfan
C. [ ] Chlorambucil
D. [X] Vincristine
E. [X] Adriablastin
91. The following drugs of choice are used for remission induction in acute myeloblastic leukemia:
A. [X] Cytarabine
B. [ ] Vincristine
C. [X] Adriablastin
D. [ ] L-asparaginase
E. [ ] All Trans-Retinoic Acid
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C. [X] Erythromelalgia
D. [ ] Sensorial neuropathy
E. [X] Epileptiform convulsions
101. Hemorrhagic complications in polycythemia vera results from:
A. [ ] Paraproteinemic syndrome
B. [X] Functional disorders of thrombocytes
C. [X] Blood hyperviscosity
D. [ ] Splenomegaly
E. [ ] Erythromelalgia
102. What of the following peripheral blood parameters are compatible with diagnosis of folic acid deficiency
anemia:
A. [ ] Thrombocytosis
B. [ ] Reticulocytosis
C. [X] Macrocytosis, hyperchromia
D. [X] Cabot rings, Jolly bodies
E. [ ] Hypochromia
103. Red cells transfusion is justified for treatment of vitamin B12- deficiency anemia in cases of:
A. [X] Anemic coma
B. [ ] Megaloblastic psychosis
C. [ ] Considerably decreased hemoglobin values
D. [ ] Total gastrectomy
E. [X] Surgical intervention according to the vital indications
104. Vitamin B12- deficiency anemia is characterized by:
A. [X] Anemic syndrome
B. [X] Neurologic syndrome
C. [X] Gastrointestinal syndrome
D. [ ] Hemorrhagic syndrome
E. [ ] DIC syndrome
105. The following morphological changes may be observed in iron-deficiency anemia:
A. [ ] Hypersegmentation of neutrophil nuclei
B. [X] Hypochromia
C. [X] Microcytosis
D. [X] Ring erythrocytes
E. [ ] Targeted red cells
106. Sideropenic syndrome is characterized by the following manifestations:
A. [X] Tastes perversion
B. [X] Angular stomatitis
C. [ ] Neurologic syndrome
D. [ ] Hemorrhagic syndrome
E. [X] Gastrointestinal syndrome
107. The following drugs are used for the treatment of aplastic anemia:
A. [ ] Totema
B. [X] Vitamin therapy
C. [X] Nerobol
D. [X] Prednisolone
E. [ ] Chlorambucil
108. The following signs may be present in megaloblastic anemia:
A. [ ] Decerased plasma iron concentration
B. [ ] Decreased plasma ferritin concentration
C. [X] Pallor with icteric nuance
D. [X] Diffuse atrophy of the gastric mucosa
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134. The following criteria should be applied for differential diagnosis between aplastic anemia and
bone marrow failure in acute leukemia:
A. [X] Splenomegaly
B. [X] Leukemic cells in the bone marrow
C. [ ] Hemorrhagic syndrome
D. [X] The bone marrow is replaced by the adipose cells
E. [ ] The infections occur frequently
135. What etiologic factors may be identified in aplastic anemia:
A. [X] Ionizing radiation
B. [ ] Increased level of erythropoietin
C. [ ] Pluripotent stem cell and hematopoietic growth factors
D. [X] Cytomegalovirus
E. [X] Chloramphenicol
136. Hemolytic anemias are characterized by:
A. [X] Increased incidence of cholelithiasis
B. [X] Shortening of erythrocyte life-span
C. [ ] Increased values of plasma haptoglobin in cases of intravascular hemolysis
D. [ ] Constant absence of splenomegaly
E. [X] Erythroid cell line hyperplasia in the bone marrow
137. What statements may be related to thalassemic syndromes:
A. [ ] Qualitative deficiency of globin chains
B. [X] Anemia is hypochromic, microcytic
C. [X] Anemia is hemolytic
D. [X] The therapy with iron preparations is contraindicated
E. [ ] The presence of poikilocytosis does not support the diagnosis of thalassemia
138. The following mechanisms may be involved in premature distruction of red cells in hemolytic anemia:
A. [ ] Increased ratio “surface/volume”
B. [X] Alteration of membrane permiability
C. [X] Alteration of membrane structure
D. [ ] Erythrocyte diameter of 7,3μ
E. [X] Precipitation of intraerythrocyte hemoglobin
139. The following statements may be compatible with diagnosis of autoimmune hemolytic anemia:
A. [ ] Cold autoantibodies are of IgG type
B. [X] Occurs in systemic lupus erythematosus
C. [X] Develops frequently in lymphoproliferative malignancies
D. [X] Glucocorticoid therapy may be one of the main treatment options
E. [ ] Paroxysmal nocturnal hemoglobinuria is one of the main types of autoimmune hemolytic anemia
140. What of the following statements are suitable for diagnosis of hemophilia:
A. [X] Is a disorder of secondary hemostasis
B. [X] Hemarthroses and hematomas occur frequently
C. [ ] Hemorrhagic syndrome in the form of petechias and ecchymoses
D. [X] Response to the treatment with fresh frozen plasma and cryoprecipitate
E. [ ] Is a disorder of primary hemostasis
141. The following statements are valuable for diagnosis of hemophilia B:
A. [ ] Is caused by the deficiency of factorului VIII
B. [X] Is similar to hemophilia A in regard to the clinical picture, evolution and complications
C. [X] Is a disorder of secondary hemostasis
D. [ ] Platelets concentrate is a practically used treatment option
E. [X] Is caused by the deficiency of factorului IX
142. What of the following manifestations are observed in hemophilia A:
A. [X] Hemarthroses and hematomas
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159. What of the following statements are uncompatible with diagnosis of chronic myeloid leukemia:
A. [ ] Presence of splenomegaly
B. [ ] Presence of leukocytosis with shift to the left
C. [X] Usage of chlorambucil for treatment
D. [X] Absence of chronic myeloid leukemia in children
E. [X] Favorable prognosis
160. There are following indications for splenectomy in idiopathic myelofibrosis:
A. [X] Severe hypersplenism
B. [X] Repeated splenic infarctions
C. [ ] The first-line therapeutic option in myeloproliferation phase
D. [ ] In cases of the marked bone marrow sclerosis
E. [X] Autoimmune hemolytic complications
161. The unfolded stage of chronic lymphocytic leukemia is characterized by:
A. [X] Generalized lymph nodes enlargement
B. [ ] Richter syndrome
C. [X] Splenomegaly
D. [X] Frequent infectious complications
E. [ ] Central nervous system involvement
162. The infectious complications in chronic lymphocytic leukemia are caused by:
A. [X] Marked neutropenia
B. [ ] Hypersplenism
C. [ ] Occurs concomitantly with Richter syndrome
D. [X] Immune deficiency
E. [X] Long-lasting treatment with glucocorticoids
163. The prognosis in chronic lymphocytic leukemia depends on:
A. [X] Phase of the disease
B. [X] Extent of lymphoid infiltartion of the bone marrow
C. [ ] Age of the patient
D. [ ] Gender
E. [X] Tumor mass at the moment of diagnosis assertion
164. What are the clinical manifestations of polycythemia vera:
A. [ ] Transient hyperemia of the face
B. [X] Constant hyperemia of the face
C. [X] Skin itching after warm shower
D. [ ] Gingival hyperplasia
E. [X] Head fullness sensation
165. There are following indications for blood exfusions as a first-line treatment in polycythemia vera:
A. [X] Benign evolution of polycythemia vera
B. [X] Fertile age of patients
C. [ ] Polycythemia vera with leukocytosis, thrombocytosis and splenomegaly
D. [ ] Severe condition of patient
E. [X] Relapses of polycythemia vera after cytotoxic treatment, associated with constant decrease of
platelet and leukocyte counts
166. The terminal phase of polycythemia vera is manifested by:
A. [X] Posterythremic myelofibrosis
B. [X] Acute leukemia
C. [ ] Chronic lymphocytic leukemia
D. [X] Chronic myeloid leukemia
E. [ ] Sarcomatization
167. Myeloma cells synthesize:
A. [X] Pathologic paraproteins
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B. [ ] Ca2+ ions
C. [X] Osteoclast-activating factor
D. [ ] Parathyroid hormone
E. [X] Bence-Jones protein
168. What of the following statements are compatible with diagnosis of autoimmune thrombocytopenia:
A. [X] Is a disorder of primary thrombocyto-vascular hemostasis
B. [X] The first relapse serves as an indication for splenectomy
C. [ ] Fresh frozen plasma is the first-line treatment option
D. [X] The main treatment comprises glucocorticoid therapy
E. [ ] Splenectomy is contraindicated
169. The treatment of autoimmune thrombocytopenia includes the administration of:
A. [ ] Cryoprecipitate
B. [X] Glucocorticoids
C. [X] Angioprotectors
D. [X] Platelets concentrate in cases of marked hemorrhagic syndrome
E. [ ] Fresh frozen plasma is the first-line treatment option
170. The following laboratory findings pleads for diagnosis of autoimmune thrombocytopenia:
A. [ ] The autocoagulation test is altered
B. [X] Decrease of thrombocyte count
C. [ ] Prolonged Lee-White coagulation time
D. [X] Bleeding time is constantly prolonged
E. [X] Megacaryocyte number is increased in the bone marrow aspirate
171. The following statements are compatible with diagnosis of Rendu-Osler disease:
A. [ ] Is a disorder of immune system
B. [X] Is a hereditary disease with autosomal dominant inheritance
C. [X] Occurs in patients of all ages
D. [X] Is one of the most frequent vascular pathology
E. [ ] Is a coagulation disorder with the disturbance of secondary hemostasis
172. The hemorrhagic syndrome in Rendu-Osler disease is manifested by:
A. [X] Epistaxis
B. [ ] Hemarthroses
C. [ ] Hematomas
D. [X] Hemoptysis
E. [X] Gastrointestinal bleeding
173. The bleeding time is prolonged in:
A. [X] Thrombocytopenias
B. [X] Thrombocytopathias
C. [ ] Hemophilia
D. [ ] Rendu-Osler disease
E. [X] Von Willebrand disease
174. The following statements are suitable for treatment of hemophilia A:
A. [X] Fresh frozen plasma is the first-line treatment option
B. [X] Transfusions of cryoprecipitate
C. [ ] Native plasma is efficient
D. [ ] Transfusions of platelets concentrate
E. [X] Human antihemophilic factor Koate-HP increases rapidly and significantly the concentration of factor VIII
175. The following treatment options may be used hemophilia B:
A. [ ] Vincristine
B. [X] Fresh frozen plasma
C. [X] Native plasma
D. [X] Medicine Novoseven
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E. [ ] Platelets concentrate
176. The following statements are suitable for treatment of hemophilia:
A. [X] The main treatment option constitutes the replacement of the deficient coagulation factor
B. [ ] The surgical treatment is widely practicable
C. [ ] The first-line treatment is erythrocytes concentrate
D. [X] High doses of cryoprecipitate and Prednisolone are recommended for treatment of patients with hemophilia
E. [X] In cases of epistaxis and postextraction dental bleeding the local hemostasis is ensured by the
application of thrombin and 5% aminocaproic acid
177. The following statements are compatible with diagnosis of chronic lymphocytic leukemia:
A. [ ] Sarcomatization does ‘t develop
B. [X] Affects persons over 45 years old and mostly males
C. [X] Leukocyte count may reach the values of several hundreds thousands
D. [X] The morphological substrate is composed of mature lymphocytes
E. [ ] Splenectomy is widely practicable
178. The terminal stage of chronic lymphocytic leukemia is manifested by:
A. [X] Body weight loss up to cachexia
B. [X] The lymph nodes, liver and the spleen are considerably enlarged
C. [ ] The performance status of patient remains satisfactory
D. [ ] Blast crisis develops frequently
E. [X] Progressive anemia and thrombocytopenia
179. Chronic lymphocytic leukemia is characterized by:
A. [ ] Leukopenia associated with lymphopenia
B. [X] Detection of Gumprecht shadows (destroyed lymphocyte nuclei)
C. [X] Lymphocytosis up to 90%
D. [X] In the unfolded stage the leukocyte count may reach the values of 500.0 – 600.0 x 109/l
E. [ ] Vascular complications: cerebral, mesenteric and venous thromboses
180. Hemolytic syndrome is manifested clinically by:
A. [ ] Skin pallor
B. [X] Pallor and jaundice of the skin
C. [ ] Skin petechias and ecchymoses
D. [X] Dark colour of the urine
E. [X] Presence of splenomegaly in certain cases
181. Intravascular hemolysis is characterized by:
A. [X] Hemoglobinemia
B. [ ] Hematuria
C. [X] Hemoglobinuria
D. [ ] Acholic stool
E. [X] Hemosiderinuria
182. Anemia chronic disorders develops due to:
A. [X] Redistribution of Fe ions with deposition in tissues
B. [ ] Disturbance of iron absorption
C. [X] Shortening of erythrocyte life-span
D. [X] Decrease of erythropoietin level
E. [ ] Disturbance of vitamin B12 absorption
183. The following statements are suitable for anemias of chronic disorders:
A. [X] Plasma iron concentartion is normal or decreased
B. [ ] Plasma iron concentartion is decreased
C. [ ] Total iron-binding capacity is increased
D. [X] Total iron-binding capacity is moderately decreased
E. [X] Normal level of serum ferritin
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184. The following statements are justified in cases of structural disturbances of erythrocyte membrane:
A. [ ] Increased elasticity
B. [X] Decreased elasticity
C. [ ] Increased plasticity
D. [X] Decreased plasticity
E. [X] Decreased selective permeability
185. Hereditary microspherocytosis is characterized clinically by:
A. [ ] Lymph nodes enlargement
B. [X] Anemic syndrome
C. [X] Hemolytic syndrome
D. [X] Splenomegaly
E. [ ] Hepatomegaly
186. Thalassemia is characterized clinically by:
A. [ ] Lymph nodes enlargement
B. [X] Anemic syndrome
C. [ ] Hemorrhagic syndrome
D. [X] Hemolytic syndrome
E. [X] Splenomegaly
187. The folowing statements are justified for thalassemia:
A. [ ] Plasma iron concentration is decreased
B. [X] Plasma iron concentration is increased
C. [ ] Serum ferritin is decreased
D. [X] Serum ferritin is increased
E. [X] The percentage of sideroblasts is increased
188. Thalassemia is characterized by the following signs:
A. [X] Pallor and jaundice of the skin
B. [X] Bone alterations
C. [X] Splenomegaly
D. [ ] Lymph nodes enlargement
E. [ ] Involvement of the pulmonary tissue
189. In Marchiafava-Micheli disease the relapse of hemolysis is caused by:
A. [X] Infectious processes
B. [X] Stresses
C. [ ] Glutathione oxidation under the action of certain drugs
D. [ ] Binding of viruses to the red cell membrane
E. [X] Physical efforts
190. The treatment of autoimmune hemolytic anemia is realized with:
A. [X] Glucocorticoids
B. [ ] Antihistaminic drugs
C. [X] Splenectomy
D. [X] Immunosuppressant drugs
E. [ ] Radiotherapy
191. Intravsacular destruction of erythrocytes takes place in:
A. [ ] Hereditary microspheocytosis
B. [X] Marchiafava-Micheli disease
C. [ ] Hereditary elliptocytosis
D. [X] March hemoglobinuria
E. [X] Hemolytic anemia associated with the deficiency of glucose–6–phosphate dehydrogenase deficiency
192. The following drugs are used for remission induction in children with acute lymphoblastic leukemia:
A. [ ] Busulfan
B. [X] Vincristine
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C. [X] L-asparaginase
D. [X] Prednisolone
E. [ ] Low doses of cytarabin
193. The following statements are justified for acute lymphoblastic leukemia:
A. [X] Positive PAS-reaction in blast cells
B. [ ] Necrotic gingivitis is characteristic
C. [X] The lymph nodes enlargement is possible
D. [ ] Presence of the skin leukemic infiltrates
E. [X] Neuroleukemia develops more frequently
194. The following criteria are important for differential diagnosis between acute leukemia and aplastic anemia:
A. [ ] Pancytopenia
B. [X] Lymph nodes enlargement
C. [X] Splenomegaly
D. [ ] Hemorrhagic syndrome
E. [X] Metaplasia of the bone marrow with blast cells
195. What of the undermentioned statements are characteristic for acute monoblastic leukemia:
A. [X] Positive PAS-reaction in blast cells
B. [ ] Increase of lysozyme concentration in the blood and urine
C. [X] Development of disseminated intravascular coagulation
D. [X] Presence of Auer rods in the blast cells
E. [ ] Gingival hyperplasia
196. The development of chronic renal failure in multiple myeloma depends on:
A. [ ] Percentage of myeloma cells in the bone marrow aspirate
B. [X] Hyperparaproteinemia
C. [ ] Anemia
D. [X] Hypercalcemia
E. [X] Blood hyperviscosity
197. What of the following statements are uncompatible with diagnosis of multiple myeloma:
A. [ ] The disease develops in elderlies
B. [ ] The disease develops slowly
C. [X] Paramyloidosis never occurs
D. [X] Leukemic conversion is not possible
E. [X] Tumor manifestation don’t occur
198. There are following clinical manifestations of paramyloidosis in multiple myeloma:
A. [ ] Bone fractures
B. [X] Macroglossia
C. [X] Different dermatoses
D. [ ] Loss of orientation
E. [X] Gastrointestinal disturbances
199. Hypercalcemia in multiple myeloma is manifested by:
A. [X] Nausea, vomiting
B. [X] Somnolence
C. [X] Loss of orientation
D. [ ] Presence of M-gradient
E. [ ] Infectious complications
200. Plethoric syndrome in polycythemia vera is manifested clinically by:
A. [ ] Lymph nodes enlargement
B. [X] Skin hyperemia
C. [X] Scleral injection
D. [ ] Skin pallor
E. [X] Positive Cuperman symptom
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201. What are the options for diagnosis assertion in the initial stage of polycythemia vera :
A. [X] Dispensarization and dynamic follow-up
B. [X] Dynamic peripheral blood count
C. [X] Bone marrow biopsy
D. [ ] Bone marrow aspiration
E. [ ] Lymph node puncture
202. The hematological transformations of erythremia in the terminal stage are:
A. [X] Anemia, thrombocytopenia
B. [X] Acute leukemia
C. [X] Posterythremic myelofibrosis
D. [ ] Hodgkin lymphoma
E. [ ] Chronic lymphocytic leukemia
203. The peripheral blood analysis in stage IIB of polycythemia vera reveals:
A. [X] Erythrocytosis
B. [ ] Thrombocytopenia
C. [X] Leukocytosis
D. [X] Shift to the left of the leukocyte count
E. [ ] Elevated ESR
204. The following syndromes are attributed to the clinical picture of aplastic anemia:
A. [ ] Neurologic syndrome
B. [X] Frequent infections
C. [X] Hemorrhagic syndrome
D. [X] Anemic syndrome
E. [X] Pancytopenia with relative lymphocytosis in the peripheral blood count
205. Folic acid-deficiency anemia is characterized by:
A. [X] Anemic syndrome
B. [ ] Neurologic syndrome
C. [X] Gastrointestinal syndrome
D. [X] Absence of neurologic syndrome
E. [X] Megaloblastic hematopiesis
206. Iron-deficiency anemia is characterized by:
A. [X] Normoblastic hematopiesis
B. [X] Sideropenic syndrome
C. [X] Gastrointestinal syndrome
D. [ ] Absence of sideropenic syndrome
E. [X] “Pica chlorotica”
207. The following syndromes are attributed to the clinical picture of vitamin B12-deficiency anemia:
A. [X] Neurologic syndrome
B. [ ] Hemorrhagic syndrome
C. [X] Anemic syndrome
D. [X] Gastrointestinal syndrome
E. [X] Funicular myelosis
208. The following criteria are important for differential diagnosis between vitamin B12-deficiency
anemia and aplastic anemia:
A. [X] Presence of neurologic syndrome
B. [ ] Absence of neurologic syndrome
C. [X] Presence of funicular myelosis
D. [X] Presence of histamine-resistant achilia
E. [X] Increase of the level of methylmalonic acid
209. The following factors are involved in the development of aplastic anemia:
A. [X] Virus hepatitis C
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E. [ ] Protein pathology
226. The unfolded stage of chronic monocytic leukemia is manifested:
A. [X] Anemic syndrome
B. [X] Splenomegaly
C. [X] Lymph nodes enlargement and hepatomegaly in rare cases
D. [ ] Lymphocytosis in the peripheral blood count
E. [X] Monocytosis in the peripheral blood count
227. The following iron preparations are used for the treatment of iron-deficieny anemia:
A. [X] Totema
B. [X] Hemofer
C. [X] Sorbifer
D. [X] Ferum lek
E. [ ] Vitamina B1
228. Sideropenic syndrome is characterized by the following manifestations:
A. [X] Hair and nails fragility
B. [X] Angular stomatitis
C. [X] Calcaneal fissures
D. [X] “Pica chlorotica”
E. [ ] Skin jaundice
229. Iron-deficiency anemia may be caused by:
A. [X] Hiatal hernia
B. [X] Uterine myoma
C. [X] Pulmonary hemosiderosis
D. [X] Transferrin deficiency
E. [ ] Splenomegaly
230. The bone marrow examination in vitamin B12 –deficiency anemia reveals:
A. [X] Hypercellularity
B. [X] Megaloblasts
C. [X] Anisocytosis and şi poikilocytosis
D. [X] Myelocytes and geant metamyelocytes
E. [ ] Hyposegmentation of neutrophil nuclei
231. The following changes may be present in megaloblastic anemia:
A. [X] Skin pallor with icteric nuance
B. [ ] Decreased values of plasma iron concentration
C. [X] Atrophy of gastric mucosa
D. [X] Megaloblastic hematopiesis
E. [X] Paresthesia in hands and feet
232. Vitamin B12-deficiency may result from:
A. [X] Deficiency or absence of intrinsic factor
B. [X] Diseases of the ilium
C. [X] Competitive consumption
D. [X] Presence of antibodies against parietal cells
E. [ ] Chronic bleeding
233. The following statements are justified for treatment of aplastic anemia:
A. [X] Cyclosporine is used as the most efficient immunosuppressant drug
B. [X] Glucocorticoid therapy should be administered in cases with hemorrhagic syndrome
C. [X] Infections frequently occur and require antibacterial therapy
D. [ ] The administration of antilymphocytic globulin worsens the existent immune deficiency
E. [X] The transfusions of leukocyte concentrate should be avoided in all cases
234. What are the etiologic factors of the acquired extraerythrocytic hemolytic anemia:
A. [X] Collagenoses
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B. [ ] Acute pneumonia
C. [X] Organic solvents
D. [X] Poisonous mushrooms
E. [X] Toxoplasmosis
235. What are the etiologic factors of the hereditary hemolytic anemia:
A. [X] Membrane spectrin deficiency
B. [ ] Increased sensibility of the erythrocyte membrane to plasma complement
C. [X] Decreased level of intraerythrocyte glutathione
D. [X] Decreased synthesis of the certain types of globin chains
E. [X] Alteration of aminoacids synthesis in globin chains
236. Autoimmune hemolytic anemia with warm antibodies is characterized by:
A. [ ] Increased permeability of the erythrocyte membrane
B. [X] Shortening of the erythrocyte life-span
C. [X] Moderate splenomegaly
D. [X] Reticulocytosis over 30‰
E. [X] Hypocellular pattern of the bone marrow
237. The following criteria are important for differential diagnosis between vitamin B12-deficiency
anemia and autoimmune hemolytic anemia with warm antibodies:
A. [ ] Splenomegaly
B. [X] Neurologic syndrome
C. [X] Reticulocytosis over 30‰
D. [X] Megaloblastic hematopoiesis
E. [X] Positive direct Coombs test
238. The following statements are justified for diagnosis of hemofilia A:
A. [ ] Glucocorticoids are widely used for treatment
B. [X] Is a hereditary coagulation disorder, caused by factor VIII deficiency
C. [X] Hematomas and hemarthroses occurs frequently
D. [X] Renal bleeding is possible
E. [X] Aminocaproic acid is contraindicated in case of hematuria
239. The patients with hemophilia may experience the following clinical manifestations:
A. [X] Gastrointestinal hemorrhages, caused by erosive gastritis or gastric/duodenal ulcer
B. [X] Retroperitoneal hematomas are dangerous
C. [X] Renal hemorrhages are registered in 14 – 30% of cases
D. [X] Long-lasting and life-threatening hemorrhages after trauma and surgical interventions
E. [ ] Tonsillectomy does not represent any threat and does not require transfusions of cryoprecipitate
and fresh frozen plasma
240. What of the following statements are compatible with diagnosis of hemophilia:
A. [X] The clinical picture depends on the degree of coagulation factor deficiency
B. [ ] Decreased platelet count
C. [X] Fresh frozen plasma and cryoprecipitate are efficient in cases of gastrointestinal hemorrhages
D. [X] Dental extractions lead to long-lasting hemorrhages
E. [X] Prolonged Lee-White coagulation time
241. The following hemorrhagic manifestations are present in patient with thrombocytopenia:
A. [X] Gingival bleeding
B. [X] Epistaxis
C. [X] Uterine bleeding
D. [ ] Hemarthroses
E. [X] Petechias
242. What of the following statements assert the diagnosis of thrombocytopenic purpura:
A. [X] Is a disorder of primary hemostasis
B. [X] Decreased platelet count in the peripheral blood analysis
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C. [ ] Marked splenomegaly
D. [X] Posthemorrhagic anemia may develop
E. [X] The first-line treatment option is glucocorticoid therapy
243. Autoimmune thrombocytopenic purpura may associate the evolution of the following diseases:
A. [ ] Rendu-Osler disease
B. [X] Chronic lymphocytic leukemia
C. [X] Chronic hepatitis
D. [X] Liver cirrhosis
E. [X] Collagenoses
244. The following hemorrhages may occur in patients with hemophilia:
A. [X] Hemarthroses and hematomas
B. [ ] Petechias and ecchymoses
C. [X] Macrohematuria
D. [X] Gastrointestinal bleeding
E. [X] Hemorrhages after dental extractions
245. What factors indicate the unfavorable evolution of Hodgkin lymphoma:
A. [X] Lymphocyte depleted histological type
B. [ ] Lymphocyte rich histological type
C. [X] Presence of systemic B symptoms
D. [X] Full age
E. [X] Stage III – IV
246. There are following signs of biological actiivity of Hodgkin lymphoma:
A. [ ] Hemoglobin less than 80 g/l
B. [X] ESR more than 30 mm/hour
C. [X] Fibrinogen above 5 g/l
D. [X] α2-globulin more than 10 g/l
E. [X] Haptoglobin above 1,5 mg % and ceruloplasmin more than 0,4 un.
247. The following statements are justified for Hodgkin lymphoma:
A. [X] The disease starts in cervicosupraclavicular lymph nodes in 75% of cases
B. [ ] The involvement of nasopharingeal lymphoid ring is frequent
C. [X] The primary involvement of mediastinal lymph nodes is typical for nodular sclerosis
D. [X] Pulmonary tissue involvement is one of the most frequent extranodal localizations
E. [X] The involvement of gastrointestinal tract is rarely registered
248. The following cytotoxic agents are used for combined chemotherapy of non-Hodgkin’s lymphomas
with high grade malignancy:
A. [ ] Busulphan
B. [X] Cyclophosphamide
C. [X] Vincristine
D. [X] Adriamycin
E. [X] Prednisolone
249. The following symptoms may occur in gastric non-Hodgkin’s lymphoma:
A. [X] Pain in epigastric region
B. [X] Dyspeptic symptoms
C. [X] Gastric bleeding
D. [ ] Cutaneous hemorrhagic syndrome
E. [X] Body weight loss
250. What of the following statements aren’t justified for non-Hodgkin’s lymphomas (NHL):
A. [X] NHL is a tumor of lymphoid tissue, which starts inside the bone marrow
B. [ ] NHL is a tumor of lymphoid tissue, which starts outside the bone marrow
C. [X] The morphological substrate of NHL is composed of plasmatic cells
D. [X] The morphological substrate of NHL is composed of mature myeloid cells
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259. There are following indications for splenectomy in hairy cell leukemia:
A. [X] Marked cytopenia
B. [X] Frequent infectious complications
C. [X] Autoimmune complications
D. [X] Massive splenomegaly
E. [ ] Generalized lymph nodes enlargement
260. Symptomatic erythrocytosis may appear in the following pathologic conditions:
A. [X] Hypernephroma
B. [X] Pickwickian syndrome
C. [ ] Acquired cardiac defects
D. [X] Cerebellar hemangioblastoma
E. [X] Congenital cardiac defects
261. There are following indications for cytotoxic chemotherapy in polycythemia vera:
A. [X] Leukocytosis
B. [X] Thrombocytosis
C. [ ] Fertile age of patients
D. [X] Splenomegaly
E. [X] The treatment with blood exfusions is not efficient
262. The following signs pleads for stage I multiple myeloma:
A. [ ] Marked osteolytic lesions
B. [X] Hemoglobin more than 100 g/l
C. [X] Normal plasma Ca concentration
D. [X] Absence of osteolytic lesions or one osteolytic focus
E. [X] Concentration of M-component: Ig G < 50 g/l, Ig A < 30 g/l, protein Bence-Jones in urine < 4 gr/24 ore
263. The following signs pleads for stage III multiple myeloma:
A. [X] Hemoglobin less than 85 g/l
B. [ ] Normal plasma Ca concentration
C. [X] Marked osteolytic lesions
D. [X] Concentration of M-component: Ig G > 70 g/l, Ig A > 50 g/l, protein Bence-Jones in the urine > 12 gr/24 ore
E. [X] Plasma Ca concentration > 12 mg/100 ml
264. Renal failure in multiple myeloma is caused by:
A. [X] Reabsorption of protein Bence-Jones
B. [X] Canalicular precipitation of micromolecular protein
C. [X] Development of ratatinated kidney
D. [ ] Renal lithiasis
E. [X] Intrarenal hydronephrosis
265. The treatment of generalized multiple myeloma comprises:
A. [X] Prolonged chemotherapy
B. [X] Intensive high-dose chemotherapy
C. [X] Radiotherapy
D. [X] Glucocorticoid therapy
E. [ ] Physiotherapy
266. What of the following clinical data pleads for diagnosis of thrombocytopenic purpura:
A. [X] Lymph nodes aren’t enlarged
B. [X] Respiratory and cardiovascular systems are intact
C. [ ] Pulmonary tissue is frequently involved
D. [X] Liver isn’t enlarged
E. [X] Moderate splenomegaly may be observed in 30% of cases
267. Autoimmune thrombocytopenia is characterized clinically by:
A. [ ] Hematomas and hemarthroses
B. [X] Petechial type of skin bleeding
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276. The following laboratory data reveal the increased destruction of erythrocytes:
A. [ ] Conjugated hyperbilirubinemia
B. [X] Unconjugated hyperbilirubinemia
C. [X] Urobilinuria
D. [X] Increase of stercobilinogen concentration
E. [X] Decrease of plasma haptoglobin concentration
277. The following signs are characteristic for anemias of chronic disorders:
A. [X] Anemia is normochromic and normocytic in the majority of cases
B. [X] Hemoglobin concentration decreases usually up to 80 – 100 g/l
C. [X] Reticulocyte count is normal or slightly increased
D. [ ] Hemoglobin concentration increases up to 170 – 180 g/l
E. [X] Leukocyte and thrombocyte counts depend on the underlying pathology
278. The following factors may exert negative impact on red cells life-span:
A. [X] Membrane structure alteration
B. [X] Intraerythrocyte enzyme deficiency
C. [X] Globin structure alteration
D. [X] Antierythrocyte antibodies formation
E. [ ] Nothing of those mentioned
279. Erythrocytes may be destroyed mechanically in patients with:
A. [X] Massive splenomegaly
B. [X] Hemangiomatosis
C. [ ] Antierythrocyte antibodies
D. [X] Prosthetic cardiac valves
E. [X] After long-lasting march
280. The following statements are justified for hereditary microspherocytosis:
A. [ ] Evolves with lymph nodes enlargement
B. [X] Splenomegaly is present
C. [X] Children may experience a growths delay
D. [X] Bone malformations may occur
E. [X] Trophic ulcers may occur on shins in a series of patients
281. Hereditary microspherocytosis is characterized by :
A. [X] Anemia associated with reticulocytosis
B. [ ] Leukcopenia
C. [X] Unconjugated hyperbilirubinemia
D. [X] Urobilinuria
E. [X] Erythroid hyperplasia of the bone marrow
282. The following drugs may induce the hemolysis in hemolytic anemia as a result of glucose–6–phosphate
dehydrogenase deficiency in red cells:
A. [X] Sulfanilamides
B. [X] Antimalarial drugs
C. [X] Nitrofuran derivatives
D. [ ] Antihistamines
E. [X] Isonicotinic acid derivatives
283. The following findings are revealed by the peripheral blood analysis in patients with thalassemia:
A. [X] Hypochromia
B. [X] Anemia
C. [X] Targeted red cells
D. [ ] Microspherocytes
E. [X] Reticulocytosis
284. The following statements are compatible with diagnosis of thalassemia:
A. [X] Erythroid hyperplasia of the bone marrow
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D. [X] Anemia
E. [X] Pathologic fractures
293. Pathologic protein syndrome in multiple myeloma is manifested by:
A. [ ] Hypercalcemia
B. [X] Hyperparaproteinemia
C. [X] Proteinuria
D. [X] Uremia
E. [X] Disturbances of peripheral microcirculatione
294. What pathologies should be differentiated from multiple myeloma, taken into consideration the
possibility of reactive plasmocytosis:
A. [ ] Polycythemia vera
B. [X] Chronic hepatitis
C. [X] Cancer
D. [X] Immune complex diseases
E. [X] Agranulocytosis
295. What immune disorders may occur in multiple myeloma:
A. [X] Monoclonal gammopathy
B. [X] Insufficiency of antibodies synthesis
C. [X] Underproduction of normal plasmatic cells
D. [X] Frequent infectious complications
E. [ ] Delayed hyperesensibility reaction
296. The diagnosis of acute leukemia is asserted on a basis of :
A. [X] Anemic syndrome
B. [X] Hemorrhagic syndrome
C. [X] Proliferative syndrome
D. [ ] Compression syndrome
E. [X] Presence of blast cells in the peripheral blood analysis and in the bone marrow aspirate
297. The following statements are justified for myelomonoblastic acute leukemia:
A. [ ] Presence of DIC syndrome
B. [X] Leukemic skin infiltration
C. [X] Necrotic lesions of tonsils and gingiva
D. [X] Positive peroxidase and sudan black reactions in blast cells
E. [X] Positive alpha-naphthyl butyrate esterase and chloroacetate esterase reaction in blast cells
298. There are following manifestations of proliferative syndrome in acute leukemias:
A. [X] Lymph nodes enlargement
B. [ ] Nectoric tonsillitis
C. [X] Splenomegaly
D. [X] Gingival hyperplasia
E. [X] Leukemic skin infiltration
299. The diagnosis of acute leukemia needs to be proved by:
A. [X] Analysis of patient’s clinical data
B. [X] Perioheral blood count
C. [X] Bone marrow examination
D. [X] Cytochemical analysis of blast cells in the bone marrow aspirate
E. [ ] Biochemical analysis of blast cells in the bone marrow aspirate
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